Organization
BON SECOURS DEPAUL MEDICAL CENTER
Active
Organization
BON SECOURS DEPAUL MEDICAL CENTER
Active
Other names
Bon Secours Contemporary Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KERNER (CHEIF EXECUTIVE OFFICER)
(757) 673-5920
Entity
Organization
Contact information
Practice address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729
Mailing address
400 GRESHAM DR, SUITE 808, NORFOLK, VA 23507-1901
(757) 622-7998
(757) 215-2729
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06209
GROUP PTAN
VA
Enumeration date
10/16/2013
Last updated
10/16/2013
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